Infant mortality rate falls, but much work remains

Infant mortality, defined as the death of a live-born infant before his or her first birthday, remains a challenge in the United States despite many technological advances, according to a report from the CDC.

Based on preliminary data, the infant mortality rate in 2011 declined to 6.05 per 1,000 live births, “but that number obscures persistent racial and geographic disparities,” researchers wrote in the Aug. 9 issue of the Morbidity and Mortality Weekly Report. African-American infants die at nearly twice the rate of white-non Hispanic infants, for example, while southern states comprise the majority of the states in the top quartile for infant mortality in the U.S.

Infant deaths mostly are a consequence of preterm birth, birth defects, adverse maternal health conditions, labor and delivery complications, lack of access to appropriate care at the time of delivery, sudden unexpected infant death and infection, according to the report.

Since 1950, medical technology has helped to steadily reduce infant mortality in the U.S., but the nation nonetheless ranked 32nd among the 34 nations of the Organization for Economic Cooperation and Development in infant mortality, and the overall IMR was three times that of the countries with the lowest IMRs: Iceland (2.2 per 1,000), Finland (2.3) and Japan (2.3).

“The main reason that the U.S. IMR remains higher than that of European nations is because the United States has a high percentage of preterm births,” the authors wrote. About 12% of U.S. births are preterm, and the country ranks 130th of 184 countries in preterm births.

Recent national and regional collaborations provide promising opportunities to improve the health of mothers before, during and after pregnancy and thus prevent many infant deaths, according to the report.

Many opportunities remain to reduce infant deaths in the U.S. by improving the health of women prior to conception, eliminating the risk of smoking during pregnancy, eliminating elective preterm deliveries, providing safe infant sleep environments and making sure high-risk infants are born in the right setting to provide the best care.

To the last point, “many very low birthweight infants in the United States are not born in hospitals that have high level III neonatal intensive-care units, which have been shown to significantly reduce mortality,” the authors wrote.